Comparison of Visual Inspection Methods with Pap Smear as Screening Test for Premalignant Lesions of the Cervix

Area of Science:

• Gynecology
• Oncology
• Public Health

Background:

• Cervical cancer screening is crucial for early detection of premalignant lesions.
• Pap smear is a common screening method, but its effectiveness can be limited.
• Visual inspection methods offer potential alternatives for cervical cancer screening.

Purpose of the Study:

• To compare the diagnostic accuracy of visual inspection methods (VIA and VILI) with Pap smear for detecting cervical premalignant lesions.
• To evaluate the sensitivity, specificity, and accuracy of each screening method.

Main Methods:

• An observational prospective study was conducted over 18 months.
• Participants underwent Papanicolaou smear (Pap smear), visual inspection with acetic acid (VIA), and visual inspection with Lugol's iodine (VILI).
• Colposcopy and cervical biopsy were performed for positive cases.

Main Results:

• Visual inspection with acetic acid (VIA) demonstrated higher sensitivity (84.21%) and accuracy (83.33%) compared to Pap smear (sensitivity 52.63%, accuracy 54.17%).
• Visual inspection with Lugol's iodine (VILI) also showed improved sensitivity (73.68%) and accuracy (70.83%) over Pap smear.
• Colposcopy yielded similar high sensitivity and accuracy as VIA.

Conclusions:

• Visual inspection methods (VIA and VILI) are effective, cost-efficient, and easily applicable screening tools for cervical premalignant lesions.
• VIA and VILI offer advantages in terms of speed and ease of use compared to Pap smear.
• These visual methods can facilitate prompt management of cervical lesions.